Haack, Jason P

Haack, Jason P is an individual health care provider with primary practice located at 191 Overthrust Rd , Evanston WY 82930-9261. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Haack, Jason P can be contacted via phone (307) 789-8721.

Contact Information

Primary practice address
191 Overthrust Rd Evanston WY 82930-9261
Phone: (307) 789-8721
Fax: (307) 789-8664
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 7953A Wyoming

Profile Details

NPI number 1407832728
LBN Legal business name Haack, Jason P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Mar 15th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1407832728 NPPES
Wyoming Other 06329001 BCBS WY
Wyoming MEDICAID 1407832728 BCBS WY
Wyoming MEDICAID 433920700 BCBS WY

Popular Providers